Malignant tumors of the digestive system - Causes, symptoms and treatment. MF.

To the digestive organs are: the esophagus, stomach, small and large intestines, as well as digestive glands: liver, salivary glands and pancreas.

The process of digestion begins with absorption and mechanical processing of food: chewing, mixing and moving it to the lower parts. The stomach is more responsible for the mechanical processing of food: mixing it and partial digestion. The main process of absorption of nutrients occurs in the small intestine, in the thick intestine only water is absorbed and feces are formed.

Of all malignant tumors of the digestive glands, cancer is almost always detected. Less common are other malignant tumors: sarcomas and stromal tumors.
Cancer of the digestive system is a malignant tumor developing from the elements of the glandular epithelium( inner lining) of the organ.

Depending on the affected organ, isolated:

- esophageal cancer,
- salivary gland cancer,
- gastrointestinal cancer,
- stomach cancer,
- small bowel cancer( rare),
- cancer of the colon and rectum,
- liver cancer,
- pancreatic cancer.

The most common of these diseases is cancer of the stomach and colon. These diseases stand on the second and third place in the occurrence among malignant tumors, after lung cancer in men and breast and sex glands in women.

Mortality from cancer of the digestive system is high and depends, first of all, on the stage of the disease, and, the more the stage, the worse the prognosis.

Malignant neoplasms of the esophagus

The causes of tumors of the esophagus include some features of nutrition, smoking. At the smokers abusing alcohol, the risk of development of a cancer of an esophagus increases in 100 times.

Among other factors: chronic diseases of the esophagus, such as chronic esophagitis( inflammation), erosion and ulcers of the esophagus, damage to the esophagus. With the development of esophageal cancer, there is often a genetic predisposition.

Symptoms of esophageal cancer are divided:

• nonspecific: weakness, sweating, body temperature rises, decreased or no appetite, weight loss.
• specific for esophageal cancer: difficulty in swallowing( dysphagia), pain behind the sternum or in the back, between the shoulder blades, excessive salivation, accumulation of saliva above the tumor( with involvement of the large nerves of the chest cavity, hoarseness, cough.)

Complications of esophageal cancer:

Hemoptysis - secretion of blood clots with sputum( with bronchial and tracheal growth of the tumor) Danger of bleeding from the tumor to an intense one, leading to the death of the patient. For tumors of large size, germinating nearby organs, There are fistulas( communicating their holes, which are not present in normal organs), such as between the esophagus and the trachea, the esophagus and the mediastinal tissue, leading to the development of severe inflammatory processes that drain the patient and lead to his death.timely treatment, as the patient "dies of hunger."

The examination of patients with esophageal cancer should include methods: X-ray examination of the esophagus with contrast, Esophagogastroscopy( FGDS), Fibroblochoscopy( FC), Computed Tomography, Ultrasound examination of the abdomen, laparoscopy, thoracoscopy.

Treatment of esophageal cancer is a rather difficult task. The difficulty lies in the large amount of surgical intervention: the removal of the entire esophagus, replacing it with another organ( part of the stomach or large intestine), is performed by cutting two cavities( thoracic and abdominal), is severely tolerated by patients, especially given that patients suffering from esophageal cancer areextremely exhausted( as a result of dysphagia and hunger).

The leading method of treatment for esophageal cancer is undoubtedly surgical. The operation can be performed only on 1-2, rarely on 3 stages of the disease, due to the close arrangement of organs in the thoracic cavity and tumor germination of vital structures that can not be removed.

At 3-4 stages of the disease, when a tumor can not be removed or the patient is severely depleted, gastrostomy is performed: holes in the stomach on the stomach through which the patient is fed.

At present, radiation therapy is quite often used.

Prognosis for esophageal cancer can be beneficial only at stage 1-2, provided adequate treatment( surgery, irradiation).At stage 3-4 the prognosis is extremely unfavorable, patients quickly die from exhaustion.

More about malignant tumors of the alimentary tract in the section of esophageal cancer.

Malignant tumors of the salivary glands

The causes of malignant tumors of the salivary glands are similar to those for cancer of the oral cavity and esophagus. These are nutritional factors: excessive use of irritants mucosal substances( smoked meat, pickles, hot and sharp foods), and the same smoking and alcohol. Predisposing factors are also attributed to genetic disorders and hereditary predisposition.

Symptoms of salivary gland cancer include: dry mouth( associated with a violation of salivation), pain in the lower or upper jaw, giving to the ear, neck or head, enlargement of the gland in size, the acquisition of rocky density, soreness, body temperature rises.

The diagnosis of salivary gland cancer is based on a visual examination and a series of examinations: ultrasound examination of the affected gland, biopsy of it( taking a piece for research).

Treatment of salivary gland tumors is only surgical, they are practically insensitive to radiation and chemotherapeutic treatment.

Like any other malignant tumor, the cancer of the salivary glands can give metastasis to the separated organs, causing the death of patients from poisoning with products of their vital activity.

Complications of salivary glands cancer: sprouting into nearby organs( auditory canal, upper or lower jaw, bottom of the mouth, neck organs, brain);bleeding from the tumor, the development of a severe inflammatory process leading to the death of the patient.

The prognosis depends on the stage of the disease, the most favorable prognosis at stage 1-2 of the process.

Malignant tumors of the stomach

occur quite often, in 2-3 place among tumorous diseases according to frequency of occurrence.

The cause of cancer development is most often food factors: excessive use of irritating mucous membranes( smoked meat, pickles, hot and sharp foods), as well as smoking and alcohol. In the development of stomach cancer, a special role is played by a special microbe - Helicobacter, which destroys the protective layer of mucus on the surface of the inner lining of the stomach.

Symptoms of stomach cancer are associated with eating and, often, at rest, the patient does not bother: heartburn, belching with air and food, nausea, in some cases vomiting, abdominal pain.

Treatment of stomach cancer, mainly surgical. If it is impossible to perform the operation, chemotherapy is used, but the effect is insignificant, radiation therapy is not used, since stomach tumors to radiation are not sensitive.

The prognosis depends on the stage of the disease: at stage 1-2, under the condition of surgery, the survival rate can reach 70%, without treatment, not one patient survives.

The disease is described in more detail in the section of stomach cancer.

Malignant tumors of large intestine

The main role in the development of colon cancer is played by chronic inflammatory processes: colitis, proctitis, sigmoiditis. Stool retention creates conditions for the contact of carcinogens with the mucosa and predisposes to the development of cancer. Benign intestinal plaques can also predispose to the development of cancer, since polyps of the intestine are often malignant. A significant role in the development of intestinal cancer is played by genetic predisposition.

By location, tumors of the intestine are divided: into cancer of the colon and rectum;in turn, colon cancer is divided into cancer of the blind, ascending, transverse, descending and sigmoid colon, depending on the part of the intestine where the tumor develops. The most common cancer of the sigmoid colon, perhaps this is due to the fact that this gut is a kind of "storage tank" for stool.

Specific symptoms of intestinal cancer do not exist, for the presence of prolonged constipation, may suggest a malignant tumor of this organ that interferes with the normal passage of stool.

Treatment of intestinal tumors, primarily surgical, which is associated with a low sensitivity of tumors to chemotherapy and frequent complications, in the form of obstruction of the intestinal lumen with the development of acute stool and gas retention, dangerous due to the occurrence of complications leading to death.

The prognosis, as with other malignant tumors of the gastrointestinal tract, depends on the stage of the disease, is most favorable at stage 1-2, at stage 4 all cancer patients die.

The topic is described in more detail in the rectal cancer section.

Malignant small intestinal tumors

Very rare, with most of them - stromal malignant tumors( from the muscular shell of the intestine, from the Latin stroma - frame, support), the cancer is practically not found. In a separate group, stromal tumors were isolated relatively recently( in the 80-90s of the last century), and referred to the so-called GIST, the English abbreviation, which translates as gastrointestinal stromal tumors of the gastrointestinal tract.

These tumors are highly malignant, grow rapidly and can give separated metastases, especially to the liver, with little or no metastasis to the nearby lymph nodes.

Symptoms of stromal tumors are characteristic of any tumor of the intestine: constipation and abdominal pain.

The diagnosis can be difficult to diagnose, since there are no specific symptoms; gastroenterologists with a diagnosis of colitis or gastritis cure for a long time, the tumor is usually detected by chance, in case of surgery for other diseases( appendicitis, gynecological operations).

In some cases, tumors are found by laparoscopy - a low-trauma study of the internal organs through puncture of the abdominal wall by camera inspection.

Treatment of small intestine tumors is only surgical.

Malignant liver tumors

The cause of liver cancer is chronic inflammatory liver diseases - hepatitis, most often caused by hepatitis B, C and D. Hepatitis is especially dangerous combination of several viruses. Liver cancer develops within 5-10 years from the onset of the disease.

Symptoms of liver cancer can be traumatic pain in the right upper quadrant, icterus of the skin, enlargement of the liver in size, all these symptoms are nonspecific, and are characteristic, primarily for hepatitis.

Most often, liver cancer develops on the background of cirrhosis( a chronic liver disease associated with the gradual destruction of liver cells and replacement of their scar tissue).

Treatment of liver cancer is primarily surgical, chemotherapeutic treatment is ineffective, to radiation treatment of the tumor is not sensitive.

The prognosis for liver cancer is poor, especially if the cancer affects both lobes and to remove the tumor is not possible. Positive results can be achieved only if the tumor is completely removed.

For more details, malignant neoplasms are described in the liver cancer section.

Malignant pancreatic tumors

Malignant pancreatic tumors are much less common than other tumors of the digestive system.

The pancreas is located in the upper abdominal cavity, is covered from above with the stomach, the liver and spleen adhere to it from the sides, the pancreatic ducts open into the duodenum together with the bile ducts, many blood vessels pass through the gland, and near it there are large nervous and vascularplexus. Taking into account the anatomy of the gland, it can be said that the tumors quickly spread to the surrounding organs, which makes it difficult to remove them.

Pancreatic tumors are represented by cancer - adenocarcinoma, which develops from the glandular tissue of the organ.

In the structure of the gland secrete the "head", "body" and "tail", the tumors develop in the head of the pancreas, which directly belongs to the back wall of the duodenum.

Specific symptoms of pancreatic cancer do not exist, but a lot of nonspecific symptoms are described: weakness, weight loss, body temperature rises, pain in the upper abdomen, lumbar region and shingles. Characteristic disorders of stool: diarrhea, clarifying the color of stool, the appearance of undigested food residues in feces. At later stages, jaundice and dryness of the skin, eye proteins, mucous membranes, dark urine, light feces appear, these are signs of mechanical jaundice( the tumor squeezes the bile ducts and blocks the outflow of bile into the intestine).When the duodenal tumor is squeezed or germinated, stagnation of food masses occurs, symptoms appear that are typical for stenosis of the outlet stomach( described in the section of stomach cancer).In some cases, with neglected tumors, it is possible to sprout into a large nerve plexus of the abdominal cavity - celiac, which is accompanied by unbearable severe pains, causing patient suffering.

Pancreatic cancer is on the rise, as are other malignant tumors, depending on the size of the focus.4 stage of the tumor: when it grows into large nearby organs or distant metastases.

Treatment of pancreatic cancer is only surgical, consists in the complete removal of the gland with the tumor, part of the stomach and the formation of artificial biliary and pancreatic ducts opening into the duodenum, in some cases leave the tail of the pancreas and perform the removal of a portion of nearby organs upon their defeat.

Radiation treatment and chemotherapy is not used due to the insensitivity of pancreatic cancer.

The prognosis is favorable only if the tumor is completely removed.